Birthmark hurts
A birthmark normally causes no pain. If pain or itching occurs, a malignant degeneration should be clarified according to the A-B-C-D-E rule (asymmetry, limitation, colorization, diameter and development). In addition to pain, itching, bleeding, scaling, or tingling may also be symptomatic and should be examined by a dermatologist. Although melanoma is not necessarily present, the birthmark should be closely monitored and its course documented.
History
Usually moles are benign and can be completely removed surgically if necessary. Once removed, a birthmark does not recur. However, a malignant tumor may develop from it, which is why it must be well observed.
Since the risks of surgical birthmark removal are relatively manageable, any noticeable skin changes are usually removed promptly. In an operation performed under local anesthesia, the mole is cut out of the skin in its entirety. During this procedure, care must be taken to maintain a sufficient distance from the surrounding skin.
The necessary safety distance depends on the thickness and diameter of the suspected mole. On average, about 1-2 centimeters of healthy skin are removed. Furthermore, the treating surgeon must ensure that all layers except for the muscle fascia are completely removed in the area of the affected skin.If the aim is to remove a conspicuous birthmark in the area of the face, the surgical procedure can be performed with the help of a special microscope (microscope-controlled surgery).
In this way, the safety distance does not have to be extended too far, thus reducing the risk of developing unsightly scars. Since malignant melanomas tend to metastasize into the bloodstream and/or lymphatic system, the removal of a tissue biopsy is usually not necessary. After removal of the birthmark, the entire skin change is sent to a suitable laboratory and examined for malignant cell strains.
If a malignant melanoma is diagnosed after removal of the birthmark, the removal of the nearby lymph nodes may be necessary. Patients can also have a conspicuous birthmark removed using a special laser (see next section). Typical complications that can occur when a patient has a conspicuous birthmark removed are allergic reactions to the local anesthetic administered and/or other materials used (sutures, disinfectants, etc.).
In addition, there is the possibility of heavy bleeding during or after the surgical treatment. For this reason, it must be ensured that blood-thinning medication (e.g. ASS or Marcumar) is discontinued before the removal of the birthmark. In some cases, infections along the wound area occur after birthmark removal.
Redness, swelling and the development of heat are the first signs of such a wound infection. With the help of a suitable antibiotic, such an infection can be quickly contained. In general, it can be said that the removal of a birthmark very rarely leads to complications.
Fear of the side effects of the operation should therefore not prevent a patient from having a potentially degenerative birthmark removed. Depending on the thickness and diameter of the birthmark in question, the prognosis after its removal varies. As a rule, small melanomas that have not persisted in the skin for a long time have a good chance of healing.
This fact is due to the fact that the metastatic tendency of a malignant melanoma is strictly dependent on the growth period. The faster a suspicious mole is removed, the lower the risk of metastasis and the better the chances of cure. Metastases of the malignant melanoma are found in most cases.
This fact makes it clear why an already metastasized mole has a poor prognosis even after the patient has had it removed.
- Brain
- Lung
- Skeleton or
- On other skin areas
A birthmark is a benign proliferation of the skin’s pigment-producing cells. If it has to be removed for cosmetic or medical (suspected malignancy) reasons, laser removal is a good option in addition to surgical removal.
For this purpose, the birthmark is cooled in advance or, if necessary, anesthetized with a local anesthetic. Depending on the color, depth and size of the mole, different wavelengths are used. The high-energy beam of the laser ensures that the target cell is heated up and even destroyed.
The laser removal is not perfect and carries the risk of recurrence. It is also possible that the birthmark only becomes paler, but does not disappear completely. However, since the suspicious tissue is severely burned by the heat of the laser, it is no longer possible to examine the tissue for malignancy.
There are many different types of lasers. From the name of the treatment method it can usually be deduced which medium is used to generate the rays, for example CO2 laser, diode laser, ruby laser. After the treatment, the skin usually reddens for a few days, and in deep and large treatment areas a slightly pinkish, light-colored spot may remain.
In the weeks before and after the treatment, sunbathing, visits to solariums and cigarette smoking should be avoided. Moles or liver spots are annoying skin symptoms for some people. For this reason, many patients come up with the most absurd ideas to get rid of the small spots.
Meanwhile even special creams are offered with which a birthmark can supposedly be removed by itself.However, no actual medical efficacy can be proven for these products. In addition, information is circulating about allegedly effective household remedies with which moles can be removed by themselves. Citric acid is to serve for example to lighten dark skin changes effectively and thus ensure that these appear less conspicuous.
Also the application of apple vinegar on the skin areas concerned is to serve to be able to remove a birthmark. In addition, some patients also use much more drastic measures. Many affected persons try to remove a birthmark by cutting it out or strangulation.
From a medical point of view, it can be said in principle that a patient should never try to remove a disturbing or conspicuous birthmark by himself. Suspicious skin changes must be examined by a dermatologist. Only a dermatologist is in a position to judge whether malignant cells are involved and whether surgical removal is necessary.
The layman is not able to conscientiously exclude the presence of a malignant melanoma despite some clues (for example the A-B-C-D-E rule). Furthermore, the removal of such a skin change should only be performed by a specialist and under local anesthesia. The anesthetic used also causes a narrowing of the smallest blood vessels and thus inhibits the blood flow in the surgical area.
Without appropriate anesthesia, the cutting out of a birthmark can be extremely painful and accompanied by heavy bleeding. In addition, the patient who removes a birthmark himself can provoke severe and sometimes life-threatening infections. The development of sepsis (blood poisoning) is also not uncommon in such independent attempts.
Patients who want to get rid of an annoying birthmark should also be aware that the improper removal of a malignant skin change can cause the transfer of degenerated cells into the blood and/or lymphatic system. In this case the development of organ metastases is likely. The fact that a suspicious mole must be removed urgently down to the muscle fascia also contradicts the assumption that complete removal by the patient himself is possible.
Furthermore, the probability of developing unattractive scars is much higher if a patient decides to remove the birthmark himself. A final argument against the independent removal of skin changes is the fact that the new formation of the birthmark has been frequently observed. A birthmark usually consists of melonocytes, i.e. cells containing melanin.
However, the birthmark often also originates from blood vessel cells, connective tissue cells or a number of other cells. Therefore, a birthmark can also develop in the eye, where all three of the above mentioned cell types are located. The diagnosis of a birthmark in the eye usually comes as a surprise to the patient, since the background of the eye cannot be seen from the outside.
A mole of the choroid, which surrounds the eyeball from behind, can only be detected by an ophthalmologist. The birthmark can also remain undetected for years (because it is asymptomatic) and can only be detected during a routine examination. If the ophthalmologist notices a change, such as sudden growth or deformation, the birthmark should be removed.
This is done either by a minor surgical operation on the eye, by laser removal or by radiotherapy. Afterwards, a follow-up at least every six months is recommended. Frequent manifestations in the eye are, besides the choroid, the eyelids, the iris and the conjunctiva. The physician also documents the findings and notes the position, size, shape, color and diameter in order to be able to assess the birthmark in its course. Ultrasound or fluorescein angiography (imaging of blood vessels) is sometimes used to improve imaging.
